Risk of recurrence after local resection of T1 rectal cancer: a meta-analysis with meta-regression.

Humans Digestive System Surgical Procedures / methods Neoplasm Recurrence, Local / epidemiology Rectal Neoplasms / pathology Transanal Endoscopic Surgery Treatment Outcome
Follow-up Local surgical resection Recurrence T1 rectal cancer Therapeutic endoscopy

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
12 2022
Historique:
received: 04 04 2022
accepted: 06 06 2022
pubmed: 1 7 2022
medline: 16 11 2022
entrez: 30 6 2022
Statut: ppublish

Résumé

T1 rectal cancer (RC) patients are increasingly being treated by local resection alone but uniform surveillance strategies thereafter are lacking. To determine whether different local resection techniques influence the risk of recurrence and cancer-related mortality, a meta-analysis was performed. A systematic search was conducted for T1RC patients treated with local surgical resection. The primary outcome was the risk of RC recurrence and RC-related mortality. Pooled estimates were calculated using mixed-effect logistic regression. We also systematically searched and evaluated endoscopically treated T1RC patients in a similar manner. In 2585 unique T1RC patients (86 studies) undergoing local surgical resection, the overall pooled cumulative incidence of recurrence was 9.1% (302 events, 95% CI 7.3-11.4%; I Patients with T1 rectal cancer may have a significantly lower recurrence risk after TEM/TAMIS compared to other local surgical resection techniques. After TEM/TAMIS and endoscopic resection the recurrence risk, cancer-related mortality and cancer-related mortality among patients with recurrence were comparable. Recurrence was mainly dependent on histological risk status.

Sections du résumé

BACKGROUND
T1 rectal cancer (RC) patients are increasingly being treated by local resection alone but uniform surveillance strategies thereafter are lacking. To determine whether different local resection techniques influence the risk of recurrence and cancer-related mortality, a meta-analysis was performed.
METHODS
A systematic search was conducted for T1RC patients treated with local surgical resection. The primary outcome was the risk of RC recurrence and RC-related mortality. Pooled estimates were calculated using mixed-effect logistic regression. We also systematically searched and evaluated endoscopically treated T1RC patients in a similar manner.
RESULTS
In 2585 unique T1RC patients (86 studies) undergoing local surgical resection, the overall pooled cumulative incidence of recurrence was 9.1% (302 events, 95% CI 7.3-11.4%; I
CONCLUSIONS
Patients with T1 rectal cancer may have a significantly lower recurrence risk after TEM/TAMIS compared to other local surgical resection techniques. After TEM/TAMIS and endoscopic resection the recurrence risk, cancer-related mortality and cancer-related mortality among patients with recurrence were comparable. Recurrence was mainly dependent on histological risk status.

Identifiants

DOI: 10.1007/s00464-022-09396-3 PMID: 35773606 PMC: PMC9652303
pubmed: 35773606
doi: 10.1007/s00464-022-09396-3
pii: 10.1007/s00464-022-09396-3
pmc: PMC9652303
doi:

Types de publication

Journal Article Meta-Analysis

Langues

eng

Sous-ensembles de citation

IM

Pagination

9156-9168

Informations de copyright

© 2022. The Author(s).

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Auteurs

Nik Dekkers (N)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. n.dekkers@lumc.nl.
ORCID: 0000-0003-0301-7011

Hao Dang (H)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Jolein van der Kraan (J)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Saskia le Cessie (S)

Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.

Philip P Oldenburg (PP)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Jan W Schoones (JW)

Directorate of Research Policy (Formerly: Walaeus Library), Leiden University Medical Center, Leiden, The Netherlands.

Alexandra M J Langers (AMJ)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Monique E van Leerdam (ME)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Jeanin E van Hooft (JE)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Yara Backes (Y)

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.

Katarina Levic (K)

Gastrounit-Surgical Division, Center for Surgical Research, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.

Alexander Meining (A)

Department of Gastroenterology, University Hospital of Würzburg, Würzburg, Germany.

Giorgio M Saracco (GM)

Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Turin, Italy.

Fabian A Holman (FA)

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Koen C M J Peeters (KCMJ)

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Leon M G Moons (LMG)

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.

Pascal G Doornebosch (PG)

Department of Surgery, IJsselland Hospital, Capelle Aan Den IJssel, The Netherlands.

James C H Hardwick (JCH)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Jurjen J Boonstra (JJ)

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Risk of recurrence after local resection of T1...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie digestive › Risk of recurrence after local resection of T1...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Risk of recurrence after local resection of T1...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du rectum › Tumeurs colorectales › Tumeurs du rectum › Risk of recurrence after local resection of T1...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Chirurgie endoscopique par orifice naturel › Chirurgie endoscopique transanale › Risk of recurrence after local resection of T1...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Risk of recurrence after local resection of T1...